What is Dumping Syndrome?Dumping syndrome is a collection of gastrointestinal and other symptoms that occur after a person eats. Food and juices moving in a quick and unregulated manner from your stomach into the intestines causes dumping syndrome. The majority of individuals that experience dumping symptoms have had a gastric bypass surgery, such as Roux-en-Y, or a surgical procedure that removes part or all of the stomach called a gastrectomy. Dumping syndrome is most likely to occur within the first few weeks following surgery or when you return to your normal diet.

What symptoms can occur as a result of dumping?Most people experience dumping symptoms immediately following a meal. In some patients, symptoms can occur one to three hours after eating. In either case, symptoms can range from mild to severe.

The following symptoms may occur during a meal or within 15-30 minutes after eating (early dumping):

  • Dizziness, lightheadedness
  • Weakness, fatigue
  • Low blood sugar
  • Sweating
  • Diarrhea
  • Shakiness
  • Anxiety
  • Heart palpitations
  • Fainting
  • Mental confusion

When symptoms develop 1-3 hours after eating (“late dumping”) they may include:

  • Bloating
  • Belching
  • Nausea
  • Abdominal pain, cramps
  • Diarrhea

Dietary recommendations for managing dumping syndrome:Individual dietary needs will vary, but below are some guidelines explaining how to more effectively manage or prevent dumping syndrome.

  • Chew well. Food that is chewed well will allow for a smoother digestive process.
  • Eat balanced, smaller meals more often. Strive to eat some healthy carbohydrates, protein, and fats at each meal and snack. Consume six mini meals every 3-4 hours throughout the day.
  • Modify your diet. Carbohydrates are one of three nutrients (along with protein and fat) that help supply the body with energy. The types of carbohydrates you choose will significantly impact how well you are able to manage or prevent dumping syndrome from occurring. It is best to eat high fiber or complex carbohydrates such as fruits, vegetables, and whole grains. These carbohydrates, combined with a balance of lean protein (such as chicken or fish) and moderate amounts of healthy fats (such as olive oil, nuts and avocados), will help maintain stable blood sugar & insulin levels and improve symptoms. Minimizing processed sugar (such as cookies, candy, and soda) will also help prevent fluctuations in insulin levels.
  • Avoid fluids with meals. Consume liquids in between meals. Avoid liquids for a half-hour before meals and a half-hour after meals. Try to drink mostly water and minimize beverages that are high in sugar.
  • Avoid alcohol.
  • Avoid dairy if you suffer from lactose intolerance or sensitivity. Certain dairy products contain large amounts of lactose (milk sugar) which can lead to insulin fluctuations and episodes of dumping. Examples: ice cream, flavored yogurts, and milk. See our lactose intolerance handout for additional information.
  • Try to eat protein at each meal and snack. A serving of protein at a main meal is the size of the palm of your hand and half that for snacks.
  • Avoid acidic foods. Tomatoes and citrus based fruits can be difficult for some to digest.
  • Increase fiber intake. Supplementing additional fiber into your diet such as psyllium, guar gum, and pectin can delay the absorption of carbohydrates in the small intestine.
  • Consume adequate vitamins, iron and calcium. Some nutrients can become depleted following stomach surgery. Make sure to consult with your healthcare provider before starting any supplements.
  • Lie down after eating. This may help slow down the digestive process.

Other Treatment Options:Your healthcare provider may recommend additional medications to help manage your dumping syndrome. These include:

  • Acarbose: this delays digestion of carbohydrates and is often used in diabetics with dumping syndrome.
  • Octreotide: anti-diarrheal that helps slow the emptying of food into the intestines.

Another treatment option for severe cases may include surgical reconstructive techniques such as reconstructing the pylorus or reversing the gastric bypass surgery. Your health care provider can also evaluate you for other medical conditions that may make you more susceptible to developing dumping syndrome.

Complications:Individuals with severe cases of dumping syndrome may develop a fear of eating, weight loss, and malnutrition. They may intentionally avoid physical activity and have a difficult time keeping a job due to the stress of needing to be near a toilet. If you experience severe weight loss, and are having a difficult time managing your symptoms, please contact your medical provider.

Prevention: It is not possible to completely prevent dumping syndrome, but dietary adjustments may decrease the severity and prevent recurrences.

Other Resources:The Zone Diet® by Dr. Barry Sears or the South Beach Diet® by Dr. Arthur Agatston are books and diet programs that support a balanced dietary approach appropriate for managing dumping syndrome.

Additional educational pieces are available at www.mngastro.com and may be helpful in managing symptoms:

  • Guidelines for Healthy Eating
  • Insulin Resistance Diet Sample Menu
  • Carbohydrate Consumption Guidelines